Maintenance hormone therapy with letrozole after first-line chemotherapy for advanced breast cancer

Gianfilippo Bertelli, Ornella Garrone, Laura Bertolotti, Marcella Occelli, Serafino Conforti, Nicola Marzano, Antonio Febbraro, Paolo Carlini, Christina Liossi, Lucia Del Mastro, Robert C F Leonard

Research output: Contribution to journalArticlepeer-review


Objectives: Maintenance hormone therapy after first-line chemotherapy is routinely used by many clinicians in advanced breast cancer patients with potentially hormone-sensitive tumors, although there are insufficient evidences in the literature to support this practice. We investigated the effects of the third-generation aromatase inhibitor letrozole as a maintenance therapy in postmenopausal patients who had responded or had stable disease with first-line chemotherapy. Methods: Fifty-eight patients (median age 62 years, range 31-80) were recruited and received letrozole, 2.5 mg/day starting within 8 weeks since the last cycle of chemotherapy. Estrogen and/or progesterone receptor status was positive in 81% of the patients, unknown in 19%; 57% of the patients had visceral disease. First-line chemotherapy included anthracyclines and/or taxanes in 74% of cases. Results: The median time to progression (TTP) from starting letrozole was 18.5 months. A shorter TTP was found in patients with abnormal CA 15-3 levels at the start of maintenance letrozole (median TTP, 9.9 months: p = 0.01), or with levels increasing >25% from baseline during the first 6 months of letrozole therapy (median TTP, 8.2 months: p <0.0001). Response status improved during letrozole in 15.5% of patients who had obtained less than a complete response to chemotherapy. Maintenance treatment was well tolerated and had no significant impact on quality of life scores. Conclusions: This study provides evidence in support of the common clinical practice of maintenance hormone therapy after chemotherapy in suitably selected patients with advanced breast cancer.

Original languageEnglish
Pages (from-to)364-370
Number of pages7
Issue number4-6
Publication statusPublished - Aug 2005


  • Breast cancer, advanced
  • CA 15-3
  • Letrozole
  • Maintenance therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


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